Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that occurs when the immune system mistakenly attacks its own body’s tissues. Most commonly, RA affects the joints of the hands, feet, wrists, elbows, knees and ankles. Unlike the wear-and-tear damage of osteoarthritis, RA affects the lining of these joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. While this disease can occur in people of all ages, it typically affects more women than men.
What causes RA is unclear, but it appears to be caused by a combination of genetic vulnerability, environmental triggers and hormonal imbalances. In women, there is a link between estrogen, progesterone and androgens that may influence the development of RA. While women are two to three times more likely to get RA than men, men tend to be affected more severely. Studies also show that women who have never had a child are twice as likely to develop RA as women who have due to the levels of estrogen during pregnancy. The peak age for RA appears to be after age 40, with the fluctuation estrogen levels.
The main symptoms of RA include pain, swelling and stiffness (often worse in the morning) along with general aching of the joints. These typically begin in the smaller, peripheral joints in the body, such as those in the fingers and toes. RA also affects joints on both sides of the body in contrast to osteoarthritis, making this a symmetrical disease. Joints affected by RA also may be warm or red along with other common symptoms of fatigue, weakness, muscle pain and depression.
Early diagnosis and treatment are important in minimizing joint destruction, so it is essential to see a doctor if tell-tale symptoms persist for a number of weeks. The doctor will usually complete an initial physical examination before making a referral to a rheumatologist. The rheumatologist will ask questions about medical history and symptoms, usually examining the joints. Blood and imaging tests are also possibilities to confirm diagnosis.
Flare-ups are temporary increases in the severity of the disease, during which the symptoms are at their peak. Some people have specific known triggers which makes the flare-ups more predictable. Common triggers include exercising too intensely or doing too much physical work. Cold weather, illness or infection, lack of sleep and stress can also trigger flare-ups.
At other times, RA symptoms are unpredictable and can come on without warning, even when a person is feeling well overall.
The symptoms of RA flare-ups may include:
- difficulty performing daily activities
- flu-like symptoms
- pain and stiffness in the joints
- pain all other the body, not limited to the joints
- swelling around the joints and tendons
RA is a severe disease that can affect the whole body, causing pain and disability. The Centers for Disease Control and Prevention (CDC) recommend those with RA to maintain a healthy weight and quit smoking. Being overweight along with smoking can worsen the RA symptoms and increase a likelihood of developing risk factors for other diseases.
The link between female hormones and the onset of RA tends to occur earlier in women than in men. The hormonal changes that can occur throughout a women’s life can affect the symptoms. Women can limit the impact of RA on their lives by seeking early treatment and following advice of a doctor when managing their symptoms.
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